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Foo20151013 2023 qo3u6t?1444774095
3
1014

Prostate and Bladder Cancer Staging and Grading - A review for students

Amended from Wikipedia and other sources T.I Lemon Stage means spread Grade means histology Prostate cancer staging – spread of the cancer There are two schemes commonly used to stage prostate cancer. TMN and Whitmore Jewett Stage I disease is cancer that is found incidentally in a small part of the sample when prostate tissue was removed for other reasons, such as benign prostatic hypertrophy, and the cells closely resemble normal cells and the gland feels normal to the examining finger Stage II more of the prostate is involved and a lump can be felt within the gland. Stage III, the tumour has spread through the prostatic capsule and the lump can be felt on the surface of the gland. In Stage IV disease, the tumour has invaded nearby structures, or has spread to lymph nodes or other organs. Grading - Gleason Grading System is based on cellular content and tissue architecture from biopsies, which provides an estimate of the destructive potential and ultimate prognosis of the disease. TX: cannot evaluate the primary tumor T0: no evidence of tumor T1: tumor present, but not detectable clinically or with imaging • T1a: tumor was incidentally found in less than 5% of prostate tissue resected (for other reasons) • T1b: tumor was incidentally found in greater than 5% of prostate tissue resected • T1c: tumor was found in a needle biopsy performed due to an elevated serum PSA T2: the tumor can be felt (palpated) on examination, but has not spread outside the prostate • T2a: the tumor is in half or less than half of one of the prostate gland's two lobes • T2b: the tumor is in more than half of one lobe, but not both • T2c: the tumor is in both lobes but within the prostatic capsule • T3: the tumor has spread through the prostatic capsule (if it is only part-way through, it is still T2) • T3a: the tumor has spread through the capsule on one or both sides • T3b: the tumor has invaded one or both seminal vesicles • T4: the tumor has invaded other nearby structures It should be stressed that the designation "T2c" implies a tumor which is palpable in both lobes of the prostate. Tumors which are found to be bilateral on biopsy only but which are not palpable bilaterally should not be staged as T2c. Evaluation of the regional lymph nodes ('N') NX: cannot evaluate the regional lymph nodes • N0: there has been no spread to the regional lymph nodes • N1: there has been spread to the regional lymph nodes Evaluation of distant metastasis ('M') • MX: cannot evaluate distant metastasis • M0: there is no distant metastasis • M1: there is distant metastasis • M1a: the cancer has spread to lymph nodes beyond the regional ones • M1b: the cancer has spread to bone • M1c: the cancer has spread to other sites (regardless of bone involvement) Evaluation of the histologic grade ('G') Usually, the grade of the cancer (how different the tissue is from normal tissue) is evaluated separately from the stage; however, for prostate cancer, grade information is used in conjunction with TNM status to group cases into four overall stages. • GX: cannot assess grade • G1: the tumor closely resembles normal tissue (Gleason 2–4) • G2: the tumor somewhat resembles normal tissue (Gleason 5–6) • G3–4: the tumor resembles normal tissue barely or not at all (Gleason 7–10) Of note, this system of describing tumors as "well-", "moderately-", and "poorly-" differentiated based on Gleason score of 2-4, 5-6, and 7-10, respectively, persists in SEER and other databases but is generally outdated. In recent years pathologists rarely assign a tumor a grade less than 3, particularly in biopsy tissue. A more contemporary consideration of Gleason grade is: • Gleason 3+3: tumor is low grade (favorable prognosis) • Gleason 3+4 / 3+5: tumor is mostly low grade with some high grade • Gleason 4+3 / 5+3: tumor is mostly high grade with some low grade • Gleason 4+4 / 4+5 / 5+4 / 5+5: tumor is all high grade Note that under current guidelines, if any Pattern 5 is present it is included in final score, regardless of the percentage of the tissue having this pattern, as the presence of any pattern 5 is considered to be a poor prognostic marker. Overall staging The tumor, lymph node, metastasis, and grade status can be combined into four stages of worsening severity. Stage Tumor Nodes Metastasis Grade Stage I T1a N0 M0 G1 Stage II T1a N0 M0 G2–4 T1b N0 M0 Any G T1c N0 M0 Any G T1 N0 M0 Any G T2 N0 M0 Any G Stage III T3 N0 M0 Any G Stage IV T4 N0 M0 Any G Any T N1 M0 Any G Any T Any N M1 Any G Bladder T (Primary tumour) • TX Primary tumour cannot be assessed • T0 No evidence of primary tumour • Ta Non-invasive papillary carcinoma • Tis Carcinoma in situ (‘flat tumour’) • T1 Tumour invades subepithelial connective tissue • T2a Tumour invades superficial muscle (inner half) • T2b Tumour invades deep muscle (outer half) • T3 Tumour invades perivesical tissue: • T3a Microscopically • T3b Macroscopically (extravesical mass) • T4a Tumour invades prostate, uterus or vagina • T4b Tumour invades pelvic wall or abdominal wall N (Lymph nodes) • NX Regional lymph nodes cannot be assessed • N0 No regional lymph node metastasis • N1 Metastasis in a single lymph node 2 cm or less in greatest dimension • N2 Metastasis in a single lymph node more than 2 cm but not more than 5 cm in greatest dimension,or multiple lymph nodes, none more than 5 cm in greatest dimension • N3 Metastasis in a lymph node more than 5 cm in greatest dimension M (Distant metastasis) • MX Distant metastasis cannot be assessed • M0 No distant metastasis • M1 Distant metastasis. Grade Urothelial papilloma – non cancerous (benign) tumour •Papillary urothelial neoplasm of low malignant potential (PUNLMP) – very slow growing and unlikely to spread •Low grade papillary urothelial carcinoma – slow growing and unlikely to spread •High grade papillary urothelial carcinoma – more quickly growing and more likely to spread  
Thomas Lemon
over 7 years ago
Foo20151013 2023 1nh0xw?1444774170
9
335

A Comedy of Errors

Great people make mistakes. Unfortunately, medicine is a subject where mistakes are not tolerated. Doctors are supposed to be infallible; or, at least, that is the present dogma. Medical students regularly fall victim to expecting too much of themselves, but this is perhaps not a bad trait when enlisting as a doctor. If it weren’t for mistakes in our understanding, then we wouldn’t progress. Studying a BSc in Anatomy has exposed me to the real world of science – where the negative is just as important as the positive. What isn’t there is just as important as what is. If you look into the history of Anatomy, it truly is a comedy of errors. So, here are three top mistakes by three incredibly influential figures who still managed to be remembered for the right reasons. 3. A Fiery Stare Culprit: Alcmaeon of Croton Go back far enough and you’ll bump into someone called Alcmaeon. Around the 5th century, he was one of the first dissectors – but not an anatomist. Alcmaeon was concerned with human intellect and was desperately searching for the seat of the soul. He made a number of major errors - quite understandable for his time! Alcmaeon insisted that sleep occurs when the blood vessels filled and we wake when they empty. Perhaps the most outrageous today is the fact that he insisted the eyes contained water both fire and water… Don’t be quick to mock. Alcmaeon identified the optic tract, the brain as the seat of the mind (along with Herophilus) and the Eustachian tubes. 2. Heart to Heart Culprit: Claudius Galen Legend has it that Galen’s father had a dream in which an angel/deity visited him and told him that his son would be a great physician. That would have to make for a pretty impressive opening line in a personal statement by today’s standards. Galen was highly influential on modern day medicine and his treatise of Anatomy and healing lasted for over a thousand years. Many of Galen’s mistakes were due to his dissections of animals rather than humans. Unfortunately, dissection was banned in Galen’s day and where his job as physician to the gladiators provided some nice exposed viscera to study, it did not allow him to develop a solid foundation. Galen’s biggest mistake lay in the circulation. He was convinced that blood flowed in a back and forth, ebb-like motion between the chambers of the heart and that it was burnt by muscle for fuel. Many years later, great physician William Harvey proposed our modern understanding of circulation. 1. The Da Vinci Code Culprit: Leonardo Da Vinci If you had chance to see the Royal Collection’s latest exhibition then you were in for a treat. It showcased the somewhat overlooked anatomical sketches of Leonardo Da Vinci. A man renowned for his intelligence and creativity, Da Vinci also turns out to be a pretty impressive anatomist. In his sketches he produces some of the most advanced 3D representations of the human skeleton, muscles and various organs. One theory of his is, however, perplexing. In his sketches is a diagram of the spinal cord……linked to penis. That’s right, Da Vinci was convinced the two were connected (no sexist comments please) and that semen production occurred inside the brain and spinal cord, being stored and released at will. He can be forgiven for the fact that he remarkably corrected himself some years later. His contributions to human physiology are astounding for their time including identification of a ‘hierarchal’ nervous system, the concept of equal ‘inheritence’ and identification of the retina as a ‘light sensing organ’. The list of errors is endless. However, they’re not really errors. They’re signposts that people were thinking. All great people fail, otherwise they wouldn’t be great.  
Lucas Brammar
about 7 years ago
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2
101

Red Flags

Red Flags typically refer to features that may suggest serious life threatening disease such as malignancy (leukaemia), infection (septic arthritis or osteomyelitis) or non-accidental injury. We also include features that may suggest inflammatory joint or muscle disease.  
pmmonline.org
about 6 years ago
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1
9

Muscle-Building Supplements Linked to Testicular Cancer

A case-control study suggests that men who use muscle-building supplements are at 65% increased risk for testicular cancer.  
medscape.com
about 6 years ago
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0
41

Anatomy Of The Sternocleidomastoid Muscle - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the anatomy of the sternocleidomastoid muscle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twit...  
youtube.com
almost 6 years ago
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0
47

Anatomy Of The Flexor Digitorum Profundus Muscle - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the anatomy of the flexor digitorum profundus muscle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me ...  
youtube.com
almost 6 years ago
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0
0

Anatomy Of The Flexor Digitorum Profundus Muscle - Everything You Need To Know - Dr. Nabil Ebraheim - YouTube

Educational video describing the anatomy of the flexor digitorum profundus muscle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me ...  
youtube.com
almost 6 years ago
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0
10

Anatomy Of The Soleus Muscle - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the anatomy of the soleus muscle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://...  
youtube.com
almost 6 years ago
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0
0

Anatomy Of The Soleus Muscle - Everything You Need To Know - Dr. Nabil Ebraheim - YouTube

Educational video describing the anatomy of the soleus muscle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://...  
youtube.com
almost 6 years ago
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0
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Actions Of The Muscles Around The Shoulder - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing actions of the muscles of the shoulder. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: ht...  
youtube.com
almost 6 years ago
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0
63

Anatomy Of The Teres Major Muscle - Everything You Need To Know

Educational video describing the anatomy of the Teres Major muscle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: htt...  
youtube.com
almost 6 years ago
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1
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Anatomy Of The Sartorius Muscle - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the anatomy of the sartorius muscle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https...  
youtube.com
almost 6 years ago
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0
43

Anatomy Of The Psoas & Iliacus Muscles - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the anatomy of the Iliopsoas muscle. Psoas Major and Iliacus muscles. Become a friend on facebook: http://www.facebook.com/drebr...  
youtube.com
almost 6 years ago
Www.bmj
0
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“It’s just a muscle sprain”

A 10 year old boy presented to his general practitioner with a four week history of left mid-thigh pain with no associated history of systemic symptoms. He had no memory of a preceding trauma and no history of infection, locally or systemically. The pain was relapsing and remitting in its extent and frequency. It was also activity related, with occasional night waking and pain at rest. His GP took a full history, conducted a complete hip examination, and at initial presentation decided that the pain was caused by a muscle sprain.  
feeds.bmj.com
almost 6 years ago
Www.bmj
0
16

Managing common symptoms of cerebral palsy in children

Cerebral palsy is a disorder of movement and posture secondary to abnormal muscle tone, spasticity being the most common abnormality of tone  
feeds.bmj.com
almost 6 years ago
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0
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How to Treat Muscle Strains and a bit on Measles

How to Treat Muscle Strains and a bit on Measles Heat or Ice? What is best to use on strained muscles? To begin this video, I cover the facts about measles a...  
youtube.com
almost 6 years ago
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0
3

Potential treatment identified for myotonic muscular dystrophy

A doctor who was one of the discoverers of the gene responsible for myotonic muscular dystrophy has now identified a therapeutic that could modify progression of muscle damage and muscle...  
medicalnewstoday.com
almost 6 years ago
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0
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Phantom limb pain: potential new treatment method for amputees

A researcher has developed a new way to treat phantom limb pain, which involves using muscle signals from the amputee's stump. The method could also help treat paralyzed patients.  
medicalnewstoday.com
almost 6 years ago